Hospital system is having trouble reaching veterans

The outsourcing of Veterans Affairs patients to metro Phoenix health providers is in full swing, but one major hospital system has encountered a challenge reaching veterans.

The VA contracts with Phoenix-based TriWest Healthcare Alliance to facilitate specialty care at community hospitals and clinics. When the VA sends a patient to TriWest, the Phoenix-based company taps its network of about 4,400 metro Phoenix doctors, hospitals and other providers to get that veteran timely care.

Banner Health, the largest metro Phoenix health system, had made appointments for 551 veterans as of last Thursday but has been unable to reach an equal number of veterans who need care.

"Our biggest concern is we are not able to reach out to about half the veterans," said Jeff Buehrle, Banner Health's chief financial officer. "We're calling three times at different times of the day."

TriWest's contract with the VA requires it to schedule an appointment within three days. If TriWest can't connect with a veteran within three days, the VA contractor sends the veteran a certified letter describing options for medical care.

While TriWest schedules the appointments, Banner Health is the only metro Phoenix health provider that has its employees staff TriWest's offices to jointly arrange appointments.

TriWest CEO David McIntyre acknowledged that some veterans can be difficult to reach in the allotted time but said TriWest has been able to reach most veterans. Last month, TriWest arranged medical care for 2,500 veterans who needed specialty care.

"It's a challenge to get a hold of people," McIntyre said. "The bottom line is you have to keep trying to reach them." — The Arizona Republic

More than two months after Sharon Helman was suspended as director of Phoenix's VA Health Care System, she remains on the payroll collecting regular checks and benefits despite passage of a new federal statute targeting accountability in the Department of Veterans Affairs.

During a wide-ranging interview Thursday at The Arizona Republic, U.S. Sen. John McCain, R-Ariz., said senior administrators should not be allowed indefinite appeals if they are fired, and should not continue to collect pay while termination is pending.

He pointed to Arizona as an example: "Right now, the ... people who really were responsible here in Phoenix, they're on (paid) administrative leave," McCain said. "What does that mean? What message does that send?"

In addition to Helman, two other top officials at Phoenix VA are under suspension: Lance Robinson, an associate director, and Brad Curry, director of Health Administration Services. None of those executives could be reached for comment.

According to VA records, Helman's pay and benefits package last year totaled $237,904. Her salary was nearly $170,000.

McCain's remarks came at the same time Concerned Veterans for America, a conservative advocacy group, announced the creation of an online petition to "Stop the Clock for Sharon Helman." The nonprofit organization described Helman as a "poster girl for the need for VA accountability," and complained she is on "paid vacation" despite inspector general findings that patient wait-times were chronically falsified under her watch.

The VA controversy erupted in April when The Republic reported on whistle-blower complaints that hundreds of patients were backlogged, and some may have died while awaiting care. The articles also alleged the VA misrepresented patient-access data, in part so employees could collect bonuses for meeting performance standards. Inspector general probes verified the practices proliferated at VA facilities nationwide.

McCain said he and Sen. Jeff Flake, R-Ariz., went to the Phoenix VA hospital for a meeting with Helman and other executives shortly after news coverage began. "They looked us in the eye and said, 'Senator, there is no basis for the allegations that are being told', " McCain noted. "I was stunned. I said, 'You mean all these people ... they're liars?' And they said, 'Yes, sir.' "

The Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, signed into law Aug. 7, removes civil service rules that have impeded efforts to discipline senior VA officials for mismanagement or misconduct. The statute gives the VA secretary firing authority similar to that of a corporate executive. However, it appears not to apply to cases such as those in Phoenix, which were initiated before the act became law.

VA Secretary Robert McDonald, who was confirmed in late July, has said he is moving as swiftly as possible to remove administrators for cause. But he declined to say how many employees are facing discipline in connection with the health-care scandal, and he emphasized that anyone accused has a right to due process.

"You've got to treat that person with respect," McDonald told reporters. "We can't talk to you about names, we can't talk to you about individuals, even though that's what you'd like. We can't do that because that would be disrespectful. ... I can tell you, we are going to hold people accountable."

McCain said he is "incredibly impressed" with McDonald and understands that the secretary is taking a "measured approach" early on. However, he added, "I would expect, frankly, within a month or so, more action."

McCain said he believes the VA should be downsized even though the reform legislation provides increased funding and manpower. He said a compromise had to be reached, and his primary objective was to increase choices for veterans — especially in rural areas — who want to obtain private health care under VA coverage.

Although the legislation enlarges the VA's budget and staffing, McCain said, declining numbers of military retirees and a rapid attrition of elderly veterans inevitably will shrink the department. "Everything dictates that the cost and size of the VA should get smaller."

McCain, a Navy pilot who became a POW during the Vietnam War, said his work on behalf of constituents largely involves complaints from veterans. For years, he said, the VA responded with evasion and obfuscation.

"Time after time we would complain, and we would get answers that we know now were not true," McCain said. "We've known for a long time about the inefficiencies at the VA. But we obviously didn't know the depth of those problems until this whole thing exploded. So, in a way, it was kind of a ticking time bomb."

McCain said McDonald must overcome "serious systemic problems." He acknowledged that VA reform efforts repeatedly failed in the past, but said he is convinced the combination of congressional oversight, media coverage, veteran outrage and new leadership will lead to real change.

"I just have to be optimistic," McCain added, "because I cannot accept the premise that we're going to fail to treat our veterans the way they deserve."